Nanostructured lipid carrier (NLC) based gel of celecoxib

Nanostructured lipid carriers (NLC) based topical gel of celecoxib was formulated for the treatment of inflammation and allied conditions. NLC prepared by the microemulsion template technique were characterized by photon correlation spectroscopy for size and scanning electron micrograph (SEM) studies. Drug encapsulation efficiency was determined using Nanosep centrifugal device. The nanoparticulate dispersion was suitably gelled and assessed for in vitro release and in vitro skin permeation using rat skin. Efficacy of the NLC gel was established using a pharmacodynamic study, i.e., aerosol-induced rat paw edema model. The skin permeation and rat paw edema pharmacodynamic studies were carried out in comparison with a micellar gel which had the same composition as that of the NLC gel except for the solid lipid and oil. The NLC based gel described in this study showed faster onset and elicited prolonged activity until 24h.     

Mitochondrial myopathies-clinicopathological features and diagnostic modalities

Mitochondrial myopathy is the term applied to a clinically and biochemically heterogeneous group of disorders which have multisystem involvement. The concept was introduced by Luft in 1962. These are due to genetic defects in the respiratory chain enzymes which are detected by histochemical, immunohistochemical stains, molecular biological studies and ultrastructural studies on muscle biopsy. Classification of the disorders can be genetic, based on defects of respiratory enzyme complexes or on the basis of the clinical syndromes. Due to the extremely variable clinical presentations of these disorders, a complete clinical and laboratory workup involving strict diagnostic criteria is essential.     

Clinically significant anemia in HIV-infected pregnant women in India is not a major barrier to zidovudine use for prevention of maternal-to-child transmission

OBJECTIVES: To determine the prevalence of anemia (serum hemoglobin <10 g/dL) and assess zidovudine use and toxicity in HIV-positive pregnant women in India. METHODS: From 2002 through 2006, 24,105 pregnant women in Pune were screened for HIV and anemia. As part of an infant prevention of mother-to-child transmission (PMTCT) trial, enrolled HIV-positive women (n = 467) were assessed for anemia and associated outcomes, comparing women receiving zidovudine for >or=2 weeks versus no zidovudine. RESULTS: The prevalence of anemia was 38.7% in HIV-positive women. Anemic women were as likely as nonanemic women to receive zidovudine. At delivery, regardless of anemia status at enrollment, women receiving >or=2 weeks of zidovudine were 70% less likely to be anemic compared with women receiving no zidovudine (odds ratio = 0.28, 95% confidence interval: 0.14 to 0.57; P < 0.01), received iron and folic acid supplements for longer periods, and had no increased adverse delivery or newborn birth outcomes. CONCLUSIONS: A significant proportion of HIV-positive pregnant women in India present for antenatal care with anemia. With concurrent iron and folic acid supplementation, however, zidovudine use is not associated with persistent or worsening anemia or associated adverse outcomes. In Indian community settings, all pregnant HIV-positive women should receive early anemia treatment. Mild anemia should not limit zidovudine use for PMTCT in India.     

Dose,duration, and animal sex predict vancomycin-associated acute kidney injury in preclinical studies

Background

Although the exposure-dependent efficacy thresholds of vancomycin have been probed, less is known about acute kidney injury (AKI) thresholds for this drug. Sensitive urinary biomarkers, such as kidney injury molecule 1 (KIM-1), have shown high sensitivity and specificity for vancomycin-associated AKI. The aims of the study were to determine if there were dose–response curves with urinary KIM-1, and to evaluate the impact of therapy duration and sex on observed relationships.

Impact of Student Reflective e-Portfolio on Medical Student Advisors

Background: Little is published about the role of faculty advisors and use of students' e-portfolios. Purpose: This article reports advisors' observations and understanding about 1st-year students based on information from students' journaling as part of an e-portfolio. Methods: Data were collected on Blackboard? survey module for 8 volunteer advisors at two medical school campuses. Responses were hand coded, verified by two authors, tallied, with example comments recorded. Results: The four male and four female advisors are all mid-career, mixed between clinical and nonclinical faculty. The students' responses in the portfolio gave advisors greater insight into students' thinking, maturity, and reflective ability, and they helped advisors identify early warnings about problems. The e-portfolio enhanced meaningful interactions and more focused discussions with students. Advisors reported no improvements in efficiency of communications and had technical difficulties with Blackboard? (version 6.0). Conclusions: Advisors reported students' reflective responses to focused questions in an e-portfolio contribute valuable understanding about students' thinking and attitudes. Advisors are enthusiastic about the value of the e-portfolio for this purpose. We anticipate benefits will generalize when fully implemented.     

Rural–Urban Differences in Dental Service Utilization Among an Early Childhood Population Enrolled in South Carolina Medicaid

Our exploratory study examined rural–urban differences in dental care utilization during early childhood among Medicaid-enrolled children aged younger than 4 years in South Carolina. We conducted a secondary data analysis using Medicaid data. Dependent variables included preventive dental visits, use of medical settings (emergency room [ER] and primary care [PC] offices) for dental reasons, receipt of fluoride varnish, and dental home status. The primary independent variable was child’s area of residence, rural or urban. The control variables were child’s age, gender, race, and special healthcare need status. In adjusted analyses, rural children were found to have significantly higher odds of lacking preventive dental visits, fluoride varnishes, and dental homes as well as using medical settings for dental reasons compared to urban children. This difference, however, was not a simple function of rural residence. Other variables such as race and special healthcare need status interacted with rurality in explaining the differences in the outcomes of interest except visiting medical settings for dental reasons. Children under age of 2 years had higher odds of undesirable outcomes compared to those aged older than 2 years. Significant disparities in dental care utilization were evident among rural, Medicaid-enrolled preschool-aged children in South Carolina. While the state has addressed Medicaid reimbursement and related policies for nearly 10 years, their impact may be disproportionately effective.     

Diagnosis and treatment of dry mouth

For effective management of dry mouth, early diagnosis and aggressive, symptom-based treatment are necessary to help alleviate much of the discomfort and to retard progression of the disorder. Many effective strategies are available to help patients manage their symptoms. Routine follow-up care with physicians and dentists is essential. With early intervention and proper individualized care, people with dry mouth should be able to lead full and comfortable lives.